ALBUMIN BUT NOT FIBRINOGEN SYNTHESIS CORRELATES WITH GALACTOSE ELIMINATION CAPACITY IN PATIENTS WITH CIRRHOSIS OF THE LIVER

Albumin and fibrinogen synthesis rates were measured in 15 subjects wi th different clinical stages of post-viral cirrhosis and compared with galactose elimination capacity and aminopyrin breath test. Forty-thre e mg per bg body weight [(2)H(5)ring]phenylalanine with an isotopic en richment of 10 atom% were intravenously injected. [(2)H(5)ring]phenyla lanine enrichments in the plasma-free phenylalanine and the albumin an d fibrinogen isolates were measured by gas chromatography-mass spectro metry. Fractional synthesis rates of albumin were normal in Child A ci rrhosis (7.6 +/- 2.2 %/d), but were lower in both Child B (3.5 +/- 0.8 %/d) and C (4.5 +/- 2.8 %/d). Absolute rates of albumin synthesis wer e (103 +/- 30 mg/kg/d) in the child A group and substantially lower in the Child B (50 +/- 3 mg/kg/d) and C (36 +/- 20 mg/kg/d) group. The a verage fractional synthesis rate of fibrinogen was 16.7 +/- 7.5 %/d an d the absolute synthesis rate 11.6 +/- 6.4 mg/kg/d. The values of the galactose elimination capacity and the aminopyrin breath test were bel ow the normal range in all patients, gradually decreasing with an incr ease in the severity of the clinical stage of cirrhosis. Albumin synth esis rates significantly correlated with the Child scores, the galacto se elimination capacity, and the aminopyrin breath test, whereas fibri nogen synthesis rates showed no such correlations.